What is a migraine trigger? In my mind there are triggers that can be eliminated and trigg....
What is a migraine trigger? In my mind there are triggers that can be eliminated and triggers that cannot be eliminated. I am often asked if the elimination of certain foods, or treating specific triggers such as allergies can cure migraine.
The short answer is no. Unfortunately, there is no cure for migraine. Migraine is a disease just like asthma and diabetes and must be managed over your lifetime. I’ve personally noticed that the biggest hurdle in getting the right migraine treatment, is getting the correct diagnosis! By the time people visit me, they may have received several incorrect diagnoses such as sinus headache, temporomandibular joint dysfunction, allergies or a spine disorder
While it’s important to rule several different things before confirming that you in fact have migraine, a quick and accurate diagnosis means starting the right treatments and pinpointing what could be contributing to the headaches you are experiencing.
Modifiable Triggers
- Dehydration
- Skipping meals
- Aged cheeses
- Citrus fruits
- Chocolate
- Foods high in monosodium glutamate
- Nuts
- Processed meats
These items do not trigger migraine in everyone. Dietary triggers are very specific to an individual person. I am often asked if there is a specific diet that can cure migraine but unfortunately there is not. There is no migraine diet. Some diets such as the keto diet can help manage migraine but are best used with the right migraine treatments under the supervision of a doctor.
While you may have a specific trigger such as alcohol or skipping meals, eliminating them does not mean you will definitely prevent migraine. On the other hand, if you are certain that alcohol, for example, inevitably triggers a migraine for you, you may restrict this. It is helpful to identify specific triggers, but there is no substitute for taking a whole body approach to migraine. Managing specific triggers, leading a healthy lifestyle, and discussing preventive and as-needed treatments with your doctor are all necessary to manage the disease effectively.
Non-dietary
- Sleeping to little or too much
- Stress or mood changes
- Obesity
- Overuse of as needed migraine medications i.e. triptans, ditan, opiates, caffeine containing medications
Non-Modifiable Triggers
- Hormonal shifts as seen in menstruation and around menopause
- Changes in the weather i.e. changes in barometric pressure
When a person with migraine can predict that a stressful period is coming or they will be having their period soon and these are reliable triggers, I often recommend a preemptive treatment. For example, I often recommend a short, 3-5 day course of medication for people who have menstrual migraine. Menstrual migraine usually starts 1-2 days before the first day of menstruation and continues to 2-3 days after menstruation has started. Patients may take a gepant, tripan or non-steroidal anti-inflammatory medication twice a day for 5 days to help prevent the severe cycle of headaches that often disable women around this time.
Ultimately, migraine is a disease that results from genetic and environmental factors and will naturally fluctuate over the lifetime. A combination of
